Enter and view: The Cedars Care Centre

Healthwatch Barnet carried out an announced Enter and View visit to The Cedars Care Centre on 13 June 2018 to assess residents’ mealtime experiences. The Cedars, part of the Forest Healthcare Group, provided nursing care for 39 residents with conditions including dementia, Parkinson’s disease, stroke and physical disabilities.

The inspection found a warm, friendly and inclusive atmosphere, with positive relationships between management, staff, residents and relatives. Relatives expressed satisfaction with the care provided and felt welcomed and involved in their family members’ care. 

Meals were prepared on site and served in three different dining areas, with residents able to choose whether to eat in communal spaces or in their rooms. The home provided a varied menu, including special diets, pureed meals, modified textures and religious dietary requirements where needed. Hydration was promoted through regular drinks service and the availability of drinks stations. 

Inspectors observed that mealtimes were generally calm and well supported, with sufficient staffing available to assist residents who required help eating. Staff treated residents respectfully and patiently, demonstrating a good understanding of individual preferences and needs. However, inspectors felt that staff could engage more verbally with residents during assisted feeding rather than relying primarily on physical reassurance.

Several aspects of the dining environment were identified as areas for improvement. Residents sometimes waited around 15 minutes for meals to be served, food was occasionally delivered to people sharing a table at different times, and one serving dish was missed during service. The process of plating and distributing food from the heated trolley created staff congestion and delays. 

The report also noted that some dining equipment was not particularly dementia-friendly. Menus were printed in small script that many residents appeared unable to read, plate settings lacked clear colour contrast, and some residents struggled to use standard cutlery. In the lounges, meals were served on white trays with white plates and napkins, making them harder to distinguish for people living with dementia. 

Healthwatch observed that many residents remained in wheelchairs during meals because their chairs did not fit under dining tables or because transferring them was impractical. The smaller lounge, which accommodated residents with greater care needs, had both a television and loud music playing throughout the meal, creating a potentially distracting environment for people with advanced dementia.

Despite these issues, feedback from residents and relatives was overwhelmingly positive. Relatives praised the home’s welcoming culture, flexibility and willingness to accommodate individual preferences, including preparing alternative meals and allowing suitable pets to live with residents. Staff, management and catering teams were seen as responsive to resident feedback and food preferences.

Overall, Healthwatch concluded that The Cedars provided a caring, welcoming and person-centred environment with strong family involvement. Recommendations included introducing more dementia-friendly dining aids and menus, improving cutlery and plate design, reviewing food service arrangements to reduce waiting times, improving the mealtime environment in the smaller lounge and providing more durable napkins. 

The home accepted the recommendations and reported that it had already sourced contrasting mats, deeper plates and coloured napkins, improved napkin quality, continued trialling adapted cutlery, reorganised food service procedures, reduced television volume during meals and begun redesigning menus to make them more accessible to residents.